The
PAVLIK HARNESS
The Pavlik Harness is specially designed to
do up strap 1. Undo strap 2 and remove
gently position your baby’s hips. It is used as
the vest. Take the new vest and put it on
a means of keeping your baby’s hip joint
your baby’s left arm and over his/her
secure. As it is impossible to secure one hip,
head. Do up strap 2 and undo strap 1.
both need to be positioned in the harness for
Take the vest over the right arm and do up
it to work. This does not mean that your baby
strap 1 .Tuck the vest down through the
has problems with both hips. By positioning
chest band.
your baby’s hips in such a way that the hip
Check that the shoulder straps are back
joint is stable, it will help normal development
on their markers and that the chest band
of the hip joint. There are several reasons
is tightened up so that you can get four
why the harness needs to be used and the
fingers between your baby’s chest and the
doctor will explain to you why it is necessary
chest band. It is a good idea to get
for your baby to be in one. It is important to
someone to help you for the first few
remember that no one is to blame. There is
times.
nothing you could have done which would 4. Knee length socks are worn beneath the
have prevented your baby’s hip problem.
lower leg straps and booties. To change
the
socks, undo both no.5 straps and
You can see an explanation of this condition
remove
one leg only from the harness.
on the back of this leaflet.
Repeat for the other leg with straps 6.
Cotton socks are best. Do not use
babygrows.
How to look after your baby in a 5. The nappy should be worn in the normal
way but MUST be worn beneath the leg
PAVLIK HARNESS
straps 3 4 7 & 8, otherwise urine burns
may occur and the harness will not
1. The Pavilk harness is designed to gently
function properly. Do not pick your baby
position your baby’s hips. The harness
up by his or her feet when changing the
must NEVER be removed, even if it is
nappy.
soiled, unless directed by a doctor.
6. Each day it is important to check the knee
2. Each week or so the position of the
creases, groin creases and sides of the
harness will be checked by the Nurse
neck for skin rubbing.
Practitioner and probably adjusted. This 7. Positioning — For sleeping place your
will allow for growth and the position of the
baby on his back. For playing lie your
hip.
baby on his/her tummy, back or in a sitting
3. Only a vest, preferably one with a collar,
position. Do not lie your baby on his/her
may be worn under the shoulder straps 1
side as it is not good for your baby’s hips
& 2 . In a few instances the straps might
at this stage.
rub. If they do make cylinder sleeves out 8. Should the harness become soiled you
of some lint, to cover the straps and this
can clean it by dampening it then applying
will prevent any rubbing. When taking the
some detergent abd scrubbing with an old
vest on and off lie your baby down and
toothbrush and nail brush. Do not take the
first loosen the chest band. Undo strap 1
harness off.
and take the right arm out of the vest. 9. You should NEVER unfasten straps 3 4 7
Take the vest over the baby’s head and
& 8.
10. When the hip joint becomes normal, as it
does in most cases, the doctor will start
allowing you to remove the harness for
certain periods of time; usually it will
begin with 1 hour in every 24 hours,
increasing at intervals.
How to look after your baby when
the PAVLIK HARNESS
is removed
6.
7.
8.
1. Once it has been decided that the harness
2.
3.
4.
5.
can be removed the Nurse Practitioner will
show you how to do this and how to put it
back on again On the first occasion it is a
good idea to get someone to help you.
When taking your baby out of the harness
lie your baby on his/her back and take the
feet out of the booties first, then undo the
chest band and shoulder straps.
When your baby is out of the harness
encourage him/her to kick. An ideal time to
do this is when your baby is in the bath.
Do NOT use baby walkers or baby
bouncers. They do not encourage the hips
to develop normally after treatment.
Swimming is good exercise once your
baby is allowed out of the harness during
9.
the day. The doctor will advise you at your
clinic visit.
You should not be worried about allowing
your baby to move freely and treat him/her
as you normally would. There are no
movements which you should prevent
your baby from doing.
Because your baby has been in the
harness it may slow his/her rate of
development. This is only a temporary
phase and he/she will soon catch up.
ln putting the harness back on stretch it
out on a flat surfact first. Place your baby
so that he/she is lying down on the back
chest band. Place the feet in first then do
up the chest band and finally each
shoulder strap to the marker.
Once your baby’s harness is off for 4
hours it is possible to wash it by hand in
warm water or on a wool programme if
you are using a washing machine. Use
non-irritant soap flakes/powder.
If you are using a washing machine close
all the buckles, place the harness in a
pillow case and tie it up. If you have a
tumble dryer keep it in the pillow case for
drying or place it on a towel over a
radiator. Sunshine, however is best of all!
THE NORMAL INFANT’S HIP JOINT
3. SUBLUXATION
The normal hip joint is very
The term Subluxation’
similar in design to a
means that the ball has
ball and socket joint.
displaced from the
In the young infant the
cup/socket but not
hip bone (‘the socket’)
completely.
This may
forms a cup made up
happen because of
of soft bone. The top of
inadequate development
the thigh bone (femur) is similar
of the cup
in shape to a ‘ball’ and is made
(see dysplasia)
of cartilage. In order for the joint# or because treatment
to develop normally it is important for dislocation is
for the hip bone (‘the socket’) and the incomplete.
thigh bone (‘the ball’) to fit together well.
The three most common reasons for the use
of the Pavlik Harness are as follows:-
ULTRASOUND
In infancy the hip joint is made of cartilage
1. CONGENITAL DISLOCATION OF
which does not show up on X-ray. Ultrasound
THE HIP
examines the joint in such a way that a
The term ‘congenital’ means that the problem diagnostic picture is formed. Ultrasound will
was present at or before birth. The word not harm your baby.
‘dislocated’ means that the top of the thigh In the early stages a weekly scan will be
bone ‘the ball’ is not in the ‘socket’ of the hip necessary to check your baby’s progress.
joint. In a Congenital
After several weeks It may be reduced to
Dislocation of the Hip
fortnightly. Once a good position is achieved
the ‘ball’ is over the
and the hip joint is developing normally it will
rim of the ‘socket’
be possible for the harness to be weaned’ off.
as in the diagram.
Congenital
This will take many weeks and possibly
Dislocation of the
months. The doctor will advise you after each
Hip is normally
Ultrasound scan on the rate of your baby’s
picked up shortly
progress.
after birth when the
doctor first examines
If there are any problems with the harness
your baby’s hips. It is most common in girls,
please contact the Nurse Practitioner on:first born babies and breech deliveries.
Southampton (023) 80794991 direct line
(answerphone service)
2. HIP DYSPLASIA
Or 023 8079 6486 Ward G3
The term ‘hip dysplasia’
means that the hip
If you have any questions about your baby’s
joint has not
hip problem please ask the nurse practitioner
developed normally.
or doctor when you attend the clinic
The socket (cup) is
usually shallow and
Southampton University Hospitals NHS Trust
the ball will displace
(see Subluxation
).